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Journal articles on the topic 'Rigid laryngoscopy'

Author: Grafiati

Published: 4 June 2021

Last updated: 16 February 2022

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1

Hastings, Randolph H., A. Christopher Vigil, Richard Hanna, Bor-Yau Yang, and David J. Sartoris. "Cervical Spine Movement during Laryngoscopy with the Bullard, Macintosh, and Miller Laryngoscopes." Anesthesiology 82, no. 4 (April 1, 1995): 859–69. http://dx.doi.org/10.1097/00000542-199504000-00007.

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Background Direct laryngoscopy requires movement of the head, neck, and cervical spine. Spine movement may be limited for anatomic reasons or because of cervical spine injury. The Bullard laryngoscope, a rigid fiberoptic laryngoscope, may cause less neck flexion and head extension than conventional laryngoscopes. The purpose of this study was to compare head extension (measured externally), cervical spine extension (measured radiographically), and laryngeal view obtained with the Bullard, Macintosh, and Miller laryngoscopes. Methods Anesthesia was induced in 35 ASA 1-3 elective surgery patients. Patients lay on a rigid board with head in neutral position. Laryngoscopy was performed three times, changing between the Bullard, Macintosh, and Miller laryngoscopes. Head extension was measured with an angle finder attached to goggles worn by the patient. The best laryngeal view with each laryngoscope was assessed by the laryngoscopist. In eight patients, lateral cervical spine radiographs were taken before and during laryngoscopy with the Bullard and Macintosh blades. Results Median values for external head extension were 11 degrees, 10 degrees, and 2 degrees with the Macintosh, Miller, and Bullard laryngoscopy (P < 0.01), respectively. Significant reductions in radiographic cervical spine extension were found for the Bullard compared to the Macintosh blade at the atlantooccipital joint, atlantoaxial joint, and C3-C4. Median atlantooccipital extension angles were 6 degrees and 12 degrees for the Bullard and Macintosh laryngoscopes, respectively. The larynx could be exposed in all patients with the Bullard but only in 90% with conventional laryngoscope (P < 0.01). Conclusions The Bullard laryngoscope caused less head extension and cervical spine extension than conventional laryngoscopes and resulted in a better view. It may be useful in care of patients in whom cervical spine movement is limited or undesirable.

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Watts, Andrew D. J., Adrian W. Gelb, David B. Bach, and David M. Pelz. "Comparison of the Bullard and Macintosh Laryngoscopes for Endotracheal Intubation of Patients with a Potential Cervical Spine Injury." Anesthesiology 87, no. 6 (December 1, 1997): 1335–42. http://dx.doi.org/10.1097/00000542-199712000-00012.

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Background In the emergency trauma situation, in-line stabilization (ILS) of the cervical spine is used to reduce head and neck extension during laryngoscopy. The Bullard laryngoscope may result in less cervical spine movement than the Macintosh laryngoscope. The aim of this study was to compare cervical spine extension (measured radiographically) and time to intubation with the Bullard and Macintosh laryngoscopes during a simulated emergency with cervical spine precautions taken. Methods Twenty-nine patients requiring general anesthesia and endotracheal intubation were studied. Patients were placed on a rigid board and anesthesia was induced. Laryngoscopy was performed on four occasions: with the Bullard and Macintosh laryngoscopes both with and without manual ILS. Cricoid pressure was applied with ILS. To determine cervical spine extension, radiographs were exposed before and during laryngoscopy. Times to intubation and grade view of the larynx were also compared. Results Cervical spine extension (occiput-C5) was greatest with the Macintosh laryngoscope (25.9 degrees +/- 2.8 degrees). Extension was reduced when using the Macintosh laryngoscope with ILS (12.9 +/- 2.1 degrees) and the Bullard laryngoscope without stabilization (12.6 +/- 1.8 degrees; P < 0.05). Times to intubation were similar for the Macintosh laryngoscope with ILS (20.3 +/- 12.8 s) and for the Bullard without ILS (25.6 +/- 10.4 s). Manual ILS with the Bullard laryngoscope results in further reduction in cervical spine extension (5.6 +/- 1.5 degrees) but prolongs time to intubation (40.3 +/- 19.5 s; P < 0.05). Conclusions Cervical spine extension and time to intubation are similar for the Macintosh laryngoscope with ILS and the Bullard laryngoscope without ILS. However, time to intubation is significantly prolonged when the Bullard laryngoscope is used in a simulated emergency with cervical spine precautions taken. This suggests that the Bullard laryngoscope may be a useful adjunct to intubation of patients with potential cervical spine injury when time to intubation is not critical.

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Aziz, Michael. "Advances in Laryngoscopy." F1000Research 4 (December 8, 2015): 1410. http://dx.doi.org/10.12688/f1000research.7045.1.

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Recent technological advances have made airway management safer. Because difficult intubation remains challenging to predict, having tools readily available that can be used to manage a difficult airway in any setting is critical. Fortunately, video technology has resulted in improvements for intubation performance while using laryngoscopy by various means. These technologies have been applied to rigid optical stylets, flexible intubation scopes, and, most notably, rigid laryngoscopes. These tools have proven effective for the anticipated difficult airway as well as the unanticipated difficult airway.

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Sánchez-Morillo, Jorge, María J. Estruch-Pérez, Maria J. Hernández-Cádiz, José M. Tamarit-Conejeros, Lorena Gómez-Diago, and Maite Richart-Aznar. "Indirect Laryngoscopy With Rigid 70-Degree Laryngoscope as a Predictor of Difficult Direct Laryngoscopy." Acta Otorrinolaringologica (English Edition) 63, no. 4 (July 2012): 272–79. http://dx.doi.org/10.1016/j.otoeng.2012.07.003.

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Pott, Leonard M., and W. Bosseau Murray. "Review of video laryngoscopy and rigid fiberoptic laryngoscopy." Current Opinion in Anaesthesiology 21, no. 6 (December 2008): 750–58. http://dx.doi.org/10.1097/aco.0b013e3283184227.

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6

Vasan, N. R., E. Kosik, B. Collins, and M. Clampitt. "Surgeon-performed intubation in awake patients utilising an anterior commissure laryngoscope with bougie: a retrospective case series." Journal of Laryngology & Otology 133, no. 11 (October 31, 2019): 986–91. http://dx.doi.org/10.1017/s0022215119002214.

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AbstractObjectiveThis retrospective case series examined the outcomes of surgeon-performed intubation using the anterior commissure rigid laryngoscope and bougie in adults with a difficult airway, including awake patients.MethodsThis study comprised a series of adult patients who underwent surgeon-performed intubation over a 10-year period. They were identified by a records search for the Current Procedural Terminology (‘CPT’) code 31500 – ‘intubation by surgeon’.ResultsForty-nine intubations performed in the operating theatre were reviewed. Intubation performed by the surgeon using the rigid anterior commissure laryngoscope was successful in 47 of the cases (96 per cent). Over half of the patients had experienced failed intubation attempts with other methods by other providers prior to the surgeon performing direct laryngoscopy. Twenty intubations were performed without paralytics and with the patient awake.ConclusionIn properly selected adults who need an urgent, secure airway in the operating theatre, surgeon-performed anterior commissure laryngoscopic intubation using a bougie should be considered a safe, reliable procedure. In most cases, this procedure can be performed in selected patients whilst awake, with sedation.

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Zhu, Z.-H., J. Zheng, L.-Y. Ying, B.-W. Zhu, J. Qian, and Z.-X. Ma. "Cross-over study of topical anaesthesia with tetracaine solution for transoral rigid laryngoscopy." Journal of Laryngology & Otology 126, no. 11 (September 11, 2012): 1150–54. http://dx.doi.org/10.1017/s002221511200182x.

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AbstractBackground:Transoral rigid laryngoscopy with videostroboscopy is the most practical method to visualise the vocal folds. The optimal topical anaesthesia regimen for transoral rigid laryngoscopy has not yet been established.Objective:To compare patient comfort and compliance with various topical anaesthetics for transoral rigid laryngoscopy.Methods:Each of 10 patients received a random topical administration of either 2 per cent lidocaine gel, 1 per cent tetracaine gel or 1 per cent tetracaine solution, 10 minutes before undergoing rigid laryngoscopy with videostroboscopy. During follow-up laryngoscopies, the agent with the lowest mean visual analogue scale score for discomfort was then used to study the timing of topical anaesthetic application: the agent was given to the patient 5, 10 or 15 minutes before laryngoscopy (with the timing randomly selected).Results:Compared with lidocaine gel or tetracaine gel, laryngoscopy with topical tetracaine solution was more comfortable. There was a statistically significant difference in discomfort score between the 5 and 10 minute application groups, but not between the 10 and 15 minute groups.Conclusion:Tetracaine solution, applied topically 10 minutes before transoral rigid laryngoscopy, significantly decreases patient discomfort.

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Kim, Hyunjee, Hoon Jung, Seong Min Hwang, and Woo Seok Yang. "Preoperative rigid laryngoscopic examination and modified jaw thrust manoeuver during fibreoptic-assisted tracheal intubation for general anaesthesia." BMJ Case Reports 14, no. 5 (May 2021): e232826. http://dx.doi.org/10.1136/bcr-2019-232826.

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Preoperative laryngoscopic examination of the airway informs general anaesthesia management and planning. However, the same glottic opening view cannot always be obtained during direct laryngoscopy of anaesthetised patients. In this case report, a patient underwent preoperative rigid laryngoscopy due to medical history, and no problems were anticipated in performing tracheal intubation; however, the direct laryngoscopic view was a Grade 4 on the Cormack-Lehane Scale after anaesthesia induction. A jaw thrust manoeuvre to facilitate fibreoptic-assisted nasotracheal intubation was not feasible. In order to compensate, a modified method of jaw thrust was implemented, where both thumbs were placed on the floor of the patient’s mouth, leading to a successful result. Safe airway management should be implemented with proper planning based on a careful preoperative evaluation.

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McGuire, Barry E., and Rhona A. Younger. "Rigid indirect laryngoscopy and optical stylets." Continuing Education in Anaesthesia Critical Care & Pain 10, no. 5 (October 2010): 148–51. http://dx.doi.org/10.1093/bjaceaccp/mkq027.

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Friedrich, Gerhard, Karl Kiesler, and Markus Gugatschka. "Curved rigid laryngoscope: missing link between direct suspension laryngoscopy and indirect techniques?" European Archives of Oto-Rhino-Laryngology 266, no. 10 (April 7, 2009): 1583–88. http://dx.doi.org/10.1007/s00405-009-0974-z.

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Benjamin, Bruce. "Thirty-Five-Millimeter Photography Using the Kantor-Berci Video Laryngoscope." Annals of Otology, Rhinology & Laryngology 107, no. 9 (September 1998): 775–78. http://dx.doi.org/10.1177/000348949810700907.

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The Kantor-Berci model II laryngoscopes employ a centrally located rigid telescope. Although the primary application is for video laryngoscopy, the system can also be used for 35-mm photography during microlaryngeal operations. The fixed, unchangeable field of view and the great depth of focus make this system ideal for photographic documentation during endolaryngeal surgery without interruption of the procedure.

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Vlajkovic, G., R. Sindjelic, D. Markovic, and M. Terzic. "A look into the larynx: Two centuries along the path of laryngoscopy." Acta chirurgica Iugoslavica 56, no. 1 (2009): 61–66. http://dx.doi.org/10.2298/aci0901061v.

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Both the design and purpose of the laryngoscope have been changed significantly since Alfred Kirstein invented his own 'laryngeal mirror' - the autoscope. An initially straight, rigid oesophageal tube has been reshaped into a number of laryngeal blade modifications, suitable for use in various patient subpopulations. A tool initially intended to help otorhynolaryngologists diagnose and treat laryngeal diseases has been transformed into an instrument intended to help anesthesiologists intubate the trachea for the purpose of either anesthesia administration or airway maintenance. As direct laryngoscopy depends greatly upon individual manual skills, there has been almost no beginner who feels no proud of his first successful intubation. Thus, we should never forget the pioneers of laryngoscopy whose curiosity, creativity, and enthusiasm enabled us to give a clear and safe look into the larynx.

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El-Ganzouri, Abdel Raouf, and Ayman Ads. "Complications of Rigid Laryngoscopy and Tracheal Intubation." Anesthesiology 117, no. 3 (September 1, 2012): 676. http://dx.doi.org/10.1097/aln.0b013e3182625512.

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Al-Helo, Sajad, Ahmed Al-Safi, and Rahma Aljanabi. "Role of videolaryngostroboscopy in the diagnosis of dysphonic patient with normal fiberoptic laryngoscopy." Iraqi National Journal of Medicine 3, no. 1 (January 15, 2021): 26–38. http://dx.doi.org/10.37319/iqnjm.3.1.3.

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Background: Dysphonia is altered voice quality, pitch, loudness, or vocal effort that impairs people’s quality of life. It is a very common complaint affecting nearly one-third of a population at some point in their life and could be caused by infection, tumor, trauma, vocal cord paralysis, etc . Indirect mirror or endoscopic laryngoscopy is used to assess the laryngeal condition in dysphonic patients seeking mainly for the cause, but frequently the findings were normal or unremarkable . Videolaryngoscopy (VLS) is very useful in dysphonic patients who have an otherwise normal indirect or flexible laryngoscopic examination. In addition to providing information regarding vocal fold vibrations, the image obtained through VLS can be magnified to make a more detailed assessment of the vocal cord anatomy than is possible with rigid of flexible laryngoscopy. Objective of study: To assess the videolaryngostroboscopic findings in dysphonic patients with normal fiber-optic laryngoscopy. Patient & Method: A cross-sectional study, Fifty patients were included in the study; They had complained of dysphonia, and the fiber-optic laryngoscopic examination was normal. Videostroboscopy were obtained for all patients to assess vocal fold vibration and seek any abnormal findings. Results: A total of 50 patients were enrolled in this study. Regarding the stroboscopic findings, 42% of the patients were normal, 15 (30%) had early soft singer’s nodules, 6 patients (12%) had intracordal lesions, 4 patients (8%)had vocal cord polypoidal changes, 2 patients (4%) had presbylaryngis, and the other 2 patients (4%) had sulcus vocalis. Conclusion: VLS is beneficial in detecting vocal cord lesions in patients with normal fiber-optic laryngoscopy. A high proportion (more than half) of dysphonic patients with normal fiber-optic laryngoscopy had abnormal findings. Keywords: Stroboscopy, Videolaryngoscopy, Fiberoptic laryngoscopy, Dysphonia.

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Leong, W. L., Y. Lim, and A. T. H. Sla. "Palatopharyngeal wall Perforation during Glidescope® Intubation." Anaesthesia and Intensive Care 36, no. 6 (November 2008): 870–74. http://dx.doi.org/10.1177/0310057x0803600620.

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We report a case of palatopharyngeal wall perforation during intubation with a GlideScope® laryngoscope. The likely mechanism was advancing and rotating the endotracheal tube against a taut palatopharyngeal fold. This was missed during the initial laryngoscopy, because there is a potential blind-spot in the oropharynx when attention is focused on the GlideScope® monitor. Fortunately, there were no sequelae other than minor bleeding and a mild sore throat and no surgical intervention was necessary. The use of unnecessary force during the endotracheal tube insertion, the use of too large a laryngoscope blade and the use of a rigid stylet could possibly also have been contributory factors to this complication.

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Matek, Jan, Frantisek Kolek, Olga Klementova, Pavel Michalek, and Tomas Vymazal. "Optical Devices in Tracheal Intubation—State of the Art in 2020." Diagnostics 11, no. 3 (March 22, 2021): 575. http://dx.doi.org/10.3390/diagnostics11030575.

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The review article is focused on developments in optical devices, other than laryngoscopes, in airway management and tracheal intubation. It brings information on advantages and limitations in their use, compares different devices, and summarizes benefits in various clinical settings. Supraglottic airway devices may be used as a conduit for fiberscope-guided tracheal intubation mainly as a rescue plan in the scenario of difficult or failed laryngoscopy. Some of these devices offer the possibility of direct endotracheal tube placement. Hybrid devices combine the features of two different intubating tools. Rigid and semi-rigid optical stylets represent another option in airway management. They offer benefits in restricted mouth opening and may be used also for retromolar intubation. Awake flexible fiberoptic intubation has been a gold standard in predicted difficult laryngoscopy for decades. Modern flexible bronchoscopes used in anesthesia and intensive care are disposable devices and contain optical lenses instead of fibers. Endotracheal tubes with an incorporated optics are used mainly in thoracic anesthesia for lung separation. They are available in double-lumen and single-lumen versions. They offer a benefit of direct view to the carina and do not require flexible fiberscope for their correct placement.

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Mekawy, Nevan M., and Sahar S. I. Badawy. "Comparative study between fibro-optic bronchoscope and rigid laryngoscope in direct laryngoscopy with microlaryngosurgery." Egyptian Journal of Anaesthesia 29, no. 3 (July 2013): 189–94. http://dx.doi.org/10.1016/j.egja.2013.01.004.

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Zhang, Fan, J. Scott McMurray, Erin E. Devine, Chao Xue, Timothy M. McCulloch, and Jack J. Jiang. "A Preliminary Case Report of a High-Quality Cost-effective Rigid Laryngoscopy Setup." Annals of Otology, Rhinology & Laryngology 126, no. 5 (February 1, 2017): 411–14. http://dx.doi.org/10.1177/0003489417693863.

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Objective: To evaluate a cost-effective modified rigid laryngoscopy setup with a portable light source and high-resolution commercially available digital camera for use in smaller otolaryngology and family practice clinics. Methods: The modified setup was used to obtain images of the larynx using both a traditional light source and a portable light source. Varying shutter speeds and ISOs were evaluated, and the optimal settings were determined for the modified setup. Results: Picture quality was adequate, and the portable light source was bright enough. ISO from 640 to 1600 with shutter speeds ranging from 1/60 to 1/160 are ideal under the normal light source, while it is better to set the ISO between 4000 and 10 000 with shutter speeds from 1/60 to 1/100 under the portable light source. Picture quality was adequate with a resolution of 2768 pixels × 1848 pixels with 350 dpi × 350 dpi. Conclusions: Results show that the modified setup obtains images of adequate quality for use in the clinic. Additionally, since the larynx requires the most illumination for endoscopic imaging, a similar setup would work for imaging the ear and nose. This setup may make laryngoscopic exams more accessible to patients at smaller laryngoscopy clinics or family practice providers.

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Gupta, Harsh Karan, and Ajay Eknath Shedge. "Diagnostic Challenge of Sulcus Vocalis Made Easier." International Journal of Phonosurgery & Laryngology 5, no. 2 (2015): 39–41. http://dx.doi.org/10.5005/jp-journals-10023-1102.

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ABSTRACT Objectives To introduce a simple diagnostic test performed with white light laryngoscopy for the diagnosis of sulcus vocalis. Materials and methods This is a retrospective observational study. A total of 14 patients with voice-related complaints and a phonatory gap on examination were included. Obvious structural and neuromuscular glottic pathologies were excluded. Phonatory gap was measured using white light rigid laryngoscopy with the technique described here. Findings were then correlated with stroboscopy. Results All 14 patients (10 U/L and 4 B/L), observed to have an asymmetric phonatory gap on white light rigid laryngoscopy, were diagnosed with sulcus vocalis. Conclusion An asymmetric phonatory gap, as seen on white light laryngoscopy and measured with the simple technique mentioned here, should make the laryngologist suspect a sulcus vocalis. However, the diagnosis needs to be confirmed by stroboscopy. How to cite this article Nerurkar NK, Gupta HK, Shedge AE. Diagnostic Challenge of Sulcus Vocalis Made Easier. Int J Phonosurg Laryngol 2015;5(2):39-41.

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Frölich, Michael A. "Mandibular Osteoma: A Case of Impossible Rigid Laryngoscopy." Anesthesiology 92, no. 1 (January 1, 2000): 261. http://dx.doi.org/10.1097/00000542-200001000-00039.

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Handler, Steven D. "Direct Laryngoscopy in Children: Rigid and Flexible Fiberoptic." Ear, Nose & Throat Journal 74, no. 2 (February 1995): 100–106. http://dx.doi.org/10.1177/014556139507400209.

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Schrader, S., A. Ovassapian, H. H. Dykes, and H. Avram. "CARDIOVASCULAR CHANGES DURING AWAKE RIGID AND FIBEROPTIC LARYNGOSCOPY." Anesthesiology 67, no. 3 (September 1, 1987): A28. http://dx.doi.org/10.1097/00000542-198709001-00028.

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Neubauer, Paul D., Laura Swibel Rosenthal, Amelia F. Drake, Carlton J. Zdanski, and Rupali N. Shah. "Rigid Laryngoscopy Is Necessary to Diagnose Laryngeal Cleft." Otolaryngology–Head and Neck Surgery 145, no. 2_suppl (August 2011): P245. http://dx.doi.org/10.1177/0194599811415823a360.

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Low, Christopher, PAM Young, Christopher J. Webb, Peter Walshe, Stephen Hone, Alessandro Panarese, and Maxwell S. Mccormick. "A simple and reliable predictor for an adequate laryngeal view with rigid endoscopic laryngoscopy." Otolaryngology–Head and Neck Surgery 132, no. 2 (February 2005): 244–46. http://dx.doi.org/10.1016/j.otohns.2004.09.037.

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OBJECTIVES: It is sometimes impossible to obtain an adequate laryngeal view during rigid endoscopic laryngoscopy. This may be due to a high tongue base. Our study seeks to determine a correlation between tongue base level and the adequacy of laryngeal view obtained with a 70-degree rigid endoscope. STUDY DESIGN AND SETTING: Over a period of 4 months, patients from a voice clinic were gathered and categorized into class I to III according to Mallampati et al (1985). Rigid laryngo-videostroboscopy was conducted to assess the larynx and the adequacy of the view was recorded. RESULTS: 74 patients were recruited. The number of adequate views were: class I = 18/20 (90%); class II = 20/33 (60.6%); class III = 7/21 (33.3%). χ2 analysis demonstrated significance trend in all 3 classes. CONCLUSION: The level of the tongue base correlated well with the adequacy of laryngeal view obtained from a 70-degree rigid endoscope. This can be used to predict the success of obtaining adequate views during rigid laryngoscopy.

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Gangwar, Anil, Vaibhav Kuchhal, and Priyanshu Srivastava. "A Rare Case of Vallecular Cyst." International Journal of Advanced and Integrated Medical Sciences 1, no. 2 (2016): 88–90. http://dx.doi.org/10.5005/jp-journals-10050-10030.

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ABSTRACT Vallecular cyst is an uncommon but potentially dangerous condition causing stridor and has been associated with sudden airway obstruction resulting in death due to its anatomical location in neonates. It may also present with feeding problems resulting in failure to thrive. Endoscopic laryngoscopy is necessary to visualize vallecular cyst when suspected clinically. Other conditions leading to neonatal stridor should be ruled out, such as laryngomalacia and other laryngotracheal abnormalities. Marsupialization with a CO2 laser is the most successful treatment. We report a case of a 6-month-old male infant referred to our ear, nose and throat department of Dr. Susheela Tiwari Hospital, Government Medical College, Haldwani, for the evaluation of inspiratory stridor, feeding difficulty, suprasternal retraction, and failure to thrive. The patient was misdiagnosed and treated conservatively by a pediatrician. On rigid laryngoscopic examination, an anteriorly displacing cystic mass on the tongue base on the left side was detected. The cyst was removed intoto using bipolar cautery. Immediately after surgery, inspiratory stridor, suprasternal retraction, and feeding difficulty improved gradually. One week later, follow-up rigid laryngoscopy showed no abnormal finding except episodic influx of epiglottis. How to cite this article Gangwar A, Kuchhal V, Srivastava P. A Rare Case of Vallecular Cyst. Int J Adv Integ Med Sci 2016;1(2):88-90.

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Businco, Lino Di Rienzo, Piergiorgio Turchio, Marco Guazzaroni, and Guido Coen Tirelli. "Virtual versus Conventional Laryngeal Endoscopy." Annals of Otology, Rhinology & Laryngology 115, no. 3 (March 2006): 182–85. http://dx.doi.org/10.1177/000348940611500304.

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We have evaluated the capacity of virtual laryngoscopy and conventional laryngoscopy conducted with a rigid or flexible instrument to visualize laryngeal structures in 64 patients with normal endoluminal anatomy. Virtual laryngoscopy allowed total visualization of laryngeal structures, including those that could not be reached by a flexible instrument. There was good correlation between virtual laryngoscopy and “real” images, indicating satisfactory diagnostic accuracy (p > .05). Although virtual laryngoscopy does not provide histologic data, it is a fast and noninvasive technique that can be added to and integrated with conventional laryngoscopy, and it can be an alternative in cases in which conventional laryngoscopy is difficult, contraindicated, or impossible. It is particularly useful for the study of laryngeal narrow spaces and in the visualization of subglottic regions and of other more restricted areas (inferior tonsil region, posterior surface of the epiglottis, glossoepiglottic vallecula, Morgagni's ventricle, anterior commissure).

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Kawaida, Masahiro, Hiroyuki Fukuda, and Naoyuki Kohno. "Multidirectional observations of the larynx using transurethral rigid endoscopes during direct laryngoscopy." Journal of Laryngology & Otology 112, no. 5 (May 1998): 464–66. http://dx.doi.org/10.1017/s0022215100140782.

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AbstractMicroscopic direct laryngoscopy (microlaryngoscopy) under general anaesthesia is the optimal method of observing the larynx. However, as microlaryngoscopy does not allow precise observations of the ventricle, inferior surface of the vocal fold and subglottis, multidirectional observations of the larynx using transurethral rigid endoscopes were performed during direct laryngoscopy. This endoscopic technique has been shown to be clinically useful in the diagnosis and treatment of laryngeal lesions. The equipment and methods are introduced herein, and a representative case is presented.

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Tulaci, Kamil Gokce, Erhan Arslan, Tugba Tulaci, and Hasmet Yazici. "Which one is favorable in the elderly? Transoral rigid laryngoscopy or transnasal flexible fiberoptic laryngoscopy." American Journal of Otolaryngology 41, no. 6 (November 2020): 102660. http://dx.doi.org/10.1016/j.amjoto.2020.102660.

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Smith, Charles E., Anna B. Pinchak, Tejbir S. Sidhu, Brian P. Radesic, Alfred C. Pinchak, and Joan F. Hagen. "Evaluation of Tracheal Intubation Difficulty in Patients with Cervical Spine Immobilization." Anesthesiology 91, no. 5 (November 1, 1999): 1253. http://dx.doi.org/10.1097/00000542-199911000-00015.

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Background The WuScope is a rigid, fiberoptic laryngoscope designed to facilitate tracheal intubation without the need for head extension. The study evaluated the WuScope in anesthetized patients with neck immobilization. Methods Patients were randomized to one of two groups: those receiving fiberoptic laryngoscopy (WuScope, n = 43) and those receiving conventional laryngoscopy (Macintosh blade, n = 44). Manual in-line stablization of the cervical spine was done during intubation. Seven parameters of intubation difficulty were measured (providing an intubation difficulty scale score): number of operators, number of attempts, number of techniques, Cormack view, lifting force, laryngeal pressure, and vocal cord position. Results Successful intubation occurred in 95% of patients in the fiberoptic group and in 93% of patients in the conventional group. There were no differences in number of attempts. In the fiberoptic group, 79% of patients had an intubation difficulty scale score of 0, representing an ideal intubation: that is, one performed by the first operator on the first attempt using the first technique with full glottic visualization. Only 18% of patients in the conventional group had an intubation difficulty scale score of 0 (P < 0.001). More patients had Cormack grade 3 or 4 views with conventional than with fiberoptic laryngoscopy (39 vs. 2%, P < 0.001). Intubation times in patients with one attempt were slightly longer in the fiberoptic (median, 25th-75th percentiles: 30, 23-53 s) compared with the conventional group (24, 17-30 s, P < 0.05). Corresponding times in patients requiring > one attempt were 155 (range, 112-201) s and 141 (range, 95-186) s in the fiberoptic and conventional groups, respectively (P value not significant). Conclusions Compared with conventional laryngoscopy, tracheal intubation using the fiberoptic laryngoscope was associated with lower intubation difficulty scale scores and better views of the laryngeal aperture in patients with cervical imnmobilization. However, there were no differences in success rates or number of intubation attempts.

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Kocamanoglu, Ismail Serhat, Elif Bengi Sener, Emre Ustun, and Ayla Tur. "Effects of Lidocaine and Prednisolone on Endoscopic Rigid Laryngoscopy." Laryngoscope 116, no. 1 (January 2006): 23–27. http://dx.doi.org/10.1097/01.mlg.0000184317.97132.f4.

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Ravi Kishore, H., and Pallavi Hosakoti. "Relevance of indirect laryngoscopy as an examination tool in present day otorhinolaryngological practice." International Journal of Otorhinolaryngology and Head and Neck Surgery 6, no. 6 (May 22, 2020): 1125. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20202212.

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<p class="abstract"><strong>Background:</strong> The objective of the study was to determine the difference in extent of laryngeal visualization between indirect laryngoscopy (IDL) mirror and rigid endoscopy (70°) and relevance of IDL in present day otolaryngological practice.</p><p class="abstract"><strong>Methods:</strong> 100 patients attending to the Department of ENT, Vijayanagara Institute of Medical Sciences, Ballari, Karnataka with complaints referable to larynx and upper digestive tract were taken up for study. All patients underwent IDL mirror and rigid endoscopic (4 mm, 70°) examination. The extent of laryngeal visualization by the clinician was recorded for each examination. </p><p class="abstract"><strong>Results:</strong> Out of 100 patients who underwent IDL mirror examination and rigid endoscopic (4 mm, 70°) examination in 87% of cases IDL mirror examination was adequate for making the diagnosis and in 11% of cases we needed rigid endoscopic examination for making the diagnosis. In 2% of cases we were not able to visualize the pathologies even with rigid endoscopy, in whom we needed other modalities of examination like radiological evidence to arrive at a diagnosis.</p><p class="abstract"><strong>Conclusions:</strong> In the present study, in 87% of the cases IDL mirror examination was adequate for making the diagnosis. Eleven cases needed rigid endoscopic (4 mm, 70°) examination to aid in diagnosis of pathologies. Even though laryngeal mirror examination is less comfortable, causing gagging for patient and may provide less complete information when compared to rigid endoscopy because of its less expensive, better depth visualization of structures and near real size images provides a versatile tool till date. Be that as it may indirect laryngoscopic mirror examination remains the mainstay of otolaryngological practice in today’s Otolaryngology practice.</p>

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Hinton, A. E., J. M. O'Connell, J. P. Van Besouw, and M. E. Wyatt. "Neonatal and paediatric fibre-optic laryngoscopy and bronchoscopy using the laryngeal mask airway." Journal of Laryngology & Otology 111, no. 4 (April 1997): 349–53. http://dx.doi.org/10.1017/s0022215100137284.

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AbstractEndoscopy of the upper airways in neonates and infants has traditionally been accomplished using rigid laryngoscopes and bronchoscopes. The laryngeal mask may be used both to control the airway for anaesthetic ventilation and to guide a fibre-optic endoscope to the laryngeal inlet and beyond.We report our experience with five neonatal and paediatric cases where fibre-optic laryngoscopy and bronchoscopy were performed through the laryngeal mask airway. All were cases in which standard rigid endoscopy had proved difficult with only a poor and restricted view of the laryngeal inlet being obtained due to the age of the infants, or abnormal anatomy of the upper airways.No problems have been encountered with maintenance of the airway or with the endoscopic view obtained. In fact in neonatal patients, this technique has been found to be preferable with regard to safety and ease of use when compared to the ventilating bronchoscope. With the size 1 laryngeal mask airway it is not possible to simultaneously ventilate and endoscope the patient. Cases included, a vascular ring, Goldenhar's syndrome, laryngomalacia, supraglottis and vocal fold paresis.This technique provides a secure method of maintaining anaesthetic ventilation during airway endoscopy, and also a means of easily locating the glottis.

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Casiano, Roy R., Vijaykumar Zaveri, and Donna S. Lundy. "Efficacy of Videostroboscopy in the Diagnosis of Voice Disorders." Otolaryngology–Head and Neck Surgery 107, no. 1 (July 1992): 95–100. http://dx.doi.org/10.1177/019459989210700115.

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While videostrobolaryngoscopy is not a new technique, its acceptance as a routine part of the voice evaluation has not been as forthcoming. Many are in agreement that the rigid fiberoptic telescopes in combination with standard VHS equipment provide a clear, magnified image that can be recorded and used for pretreatment and post-treatment comparisons, documentation, teaching, and research. Yet, some skepticism persists with regard to the ability of videolaryngoscopy and/or videostrobolaryngoscopy in changing the diagnosis and treatment outcome of patients with voice disorders as compared to indirect laryngoscopy. Two hundred ninety-two dysphonic patients were identified who underwent indirect as well as videolaryngoscopy with and without stroboscopic examination. Videostrobolaryngoscopy was found to alter the diagnosis and treatment outcome in 14% of the patients. It is most useful in patients with a diagnosis of functional dysphonia and vocal fold paralysis by indirect laryngoscopy. The increased illumination and magnification afforded by rigid fiberoptic telescopes during videolaryngoscopy, combined with the detailed assessment of glottic closure, mucosal wave, and amplitude characteristics provided by stroboscopic examination, allowed detection of subtle vocal fold pathology, otherwise missed by indirect laryngoscopy.

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Smith, Charles E., Tejbir S. Sidhu, Jonathan Lever, and Anna B. Pinchak. "The Complexity of Tracheal Intubation Using Rigid Fiberoptic Laryngoscopy (WuScope)." Anesthesia & Analgesia 89, no. 1 (July 1999): 236–39. http://dx.doi.org/10.1213/00000539-199907000-00043.

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Getachew, Yohannes B., Ramez M. Salem, and Ninos J. Joseph. "Does the Sniffing Position Facilitate Laryngeal Visualization during Rigid Laryngoscopy?" Anesthesiology 96, Sup 2 (September 2002): A1080. http://dx.doi.org/10.1097/00000542-200209002-01080.

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Smith, Charles E., Tejbir S. Sidhu, Jonathan Lever, and Anna B. Pinchak. "The Complexity of Tracheal Intubation Using Rigid Fiberoptic Laryngoscopy (WuScope)." Anesthesia & Analgesia 89, no. 1 (July 1999): 236–39. http://dx.doi.org/10.1097/00000539-199907000-00043.

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Garg, Sunil. "Correlation between Rigid Laryngoscopy and Histopathology of Laryngeal Lesions at Our Voice Clinic." International Journal of Phonosurgery & Laryngology 1, no. 1 (2011): 29–31. http://dx.doi.org/10.5005/jp-journals-10023-1007.

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ABSTRACT Introduction In today's world of rapid technological advances, the medical field is developing at a rapid speed. Various sophisticated tools are available for the diagnostic work-up of patients with voice disorders. These are stroboscopy, optical coherence tomography (OCT), contact endoscopy and laryngeal USG, which gives sophisticated details of the larynx. However, at present most of these modalities are expensive and available only at few research centers. Rigid laryngoscopy is a noninvasive, easily available and fairly accurate diagnostic tool in patients with voice disorders. Aims and objectives The aim of our study was to assess the diagnostic potential of rigid laryngoscopy in different laryngeal lesions and its correlation with histopathology. This is a one year retrospective study at our voice clinic at Bombay Hospital, Mumbai. Patients and methods We examined 720 patients at our voice clinic from January 2008 to December 2008. Microlaryngeal surgery was performed on 59 of these. The clinical diagnosis was made after detailed history taking and clinical examination by a 70 degree Hopkins rod telescope. Results In our study, clinical diagnosis was 100% accurate in vocal fold subepithelial cyst, vocal fold nodules, laryngeal papilloma and contact granuloma. The clinical diagnosis had a reliability of 30% for Vocal fold polyps, 50% for leukoplakia, and 66% for malignant lesion. In suspected laryngeal polyps, leukoplakia and malignancy, our study indicates that we need to excise the lesion surgically and prove the histopathology. Conclusion Every tissue removed during laryngeal surgery should be sent for histopathology. Rigid Laryngoscopy is a safe and accurate tool to diagnose nodules and cysts.

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Kocamanoglu, I. S., S. Cengel Kurnaz, and A. Tur. "Effects of lignocaine on pressor response to laryngoscopy and endotracheal intubation during general anaesthesia in rigid suspension laryngoscopy." Journal of Laryngology & Otology 129, no. 1 (December 15, 2014): 79–85. http://dx.doi.org/10.1017/s0022215114003077.

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AbstractObjective:This study aimed to compare the effects of topical and systemic lignocaine on the circulatory response to direct laryngoscopy performed under general anaesthesia.Methods:Ninety-nine patients over 20 years of age, with a physical status of I–II (classified according to the American Society of Anesthesiologists), were randomly allocated to 3 groups. One group received 5 ml of 0.9 per cent physiological saline intravenously, one group received 1.5 mg/kg lignocaine intravenously, and another group received seven puffs of 10 per cent lignocaine aerosol applied topically to the airway. Mean arterial pressures, heart rates and peripheral oxygen saturations were recorded, and changes in mean arterial pressure and heart rate ratios were calculated.Results:Changes in the ratios of mean arterial pressure and heart rate were greater in the saline physiological group than the other groups at 1 minute after intubation. Changes in the ratios of mean arterial pressure (at the same time point) were greater in the topical lignocaine group than in the intravenous lignocaine group, but this finding was not statistically significant.Conclusion:Lignocaine limited the haemodynamic responses to laryngoscopy and endotracheal intubation during general anaesthesia in rigid suspension laryngoscopy.

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Schutte, Henrieke W., Robert P. Takes, Piet J. Slootweg, Marianne J. P. A. Arts, Jimmie Honings, Frank J. A. van den Hoogen, Henri A. M. Marres, and Guido B. van den Broek. "Digital Video Laryngoscopy and Flexible Endoscopic Biopsies as an Alternative Diagnostic Workup in Laryngopharyngeal Cancer: A Prospective Clinical Study." Annals of Otology, Rhinology & Laryngology 127, no. 11 (September 7, 2018): 770–76. http://dx.doi.org/10.1177/0003489418793987.

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Objectives: An office-based workup strategy for patients with laryngopharyngeal lesions suspicious for carcinoma is analyzed. The feasibility of office-based transnasal flexible endoscopic biopsies under local anesthesia and the impact on the diagnostic workup are evaluated. Methods: This study is a prospective analysis of patients with laryngeal, oropharyngeal, and hypopharyngeal lesions suspicious for carcinoma. One hundred eighty-eight participants were divided into 2 groups. The first group underwent an office-based biopsy procedure under local anesthesia using a flexible digital video laryngoscope with instrument channel (n = 53), and the second group underwent a biopsy procedure under general anesthesia using rigid laryngopharyngoscopy (n = 135). Results: Office-based flexible endoscopic biopsies were tolerated well, and there were no complications. These biopsies were 92.5% successful in acquiring a definitive diagnosis. Costs were reduced. Diagnostic workup time and time until start of therapy were reduced to 2 days and 27 days, respectively. Conclusion: Office-based biopsy under local anesthesia using flexible digital video laryngoscopy is safe, cost-effective, and successful in providing a histopathological diagnosis. It reduces the diagnostic workup time significantly in patients with laryngeal, oropharyngeal, and hypopharyngeal cancer, while also reducing the necessity to subsequently perform a rigid laryngopharyngoscopy under general anesthesia.

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Clark, Bhavishya S., William Z. Gao, Caitlin Bertelsen, Janet S. Choi, Hagit Shoffel‐Havakuk, Lindsay S. Reder, Edie R. Hapner, Michael M. Johns, and Karla O'Dell. "Flexible versus rigid laryngoscopy: A randomized crossover study comparing patient experience." Laryngoscope 130, no. 11 (January 6, 2020): 2663–66. http://dx.doi.org/10.1002/lary.28491.

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Muscarella, L. F. "Reassessment of the risk of healthcare-acquired infection during rigid laryngoscopy." Journal of Hospital Infection 68, no. 2 (February 2008): 101–7. http://dx.doi.org/10.1016/j.jhin.2007.11.004.

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Ali, Qazi Ehsan, Bikramjit Das, Syed Hussain Amir, Obaid Ahmed Siddiqui, and Shaista Jamil. "Comparison of the Airtraq and McCoy laryngoscopes using a rigid neck collar in patients with simulated difficult laryngoscopy." Journal of Clinical Anesthesia 26, no. 3 (May 2014): 199–203. http://dx.doi.org/10.1016/j.jclinane.2013.10.012.

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Choy, A. T. K., P. G. C. Gluckman, M. C. F. Tong, and C. A. Van Hasselt. "Flexible nasopharyngoscopy for fish bone removal from the pharynx." Journal of Laryngology & Otology 106, no. 8 (August 1992): 709–11. http://dx.doi.org/10.1017/s002221510012064x.

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AbstractThe use of flexible nasopharyngoscopy with biopsy forceps for the removal of fish bones found in the oropharynx and hypopharynx is described. One hundred and sixty-eight patients with ingested fish bones in the upper aero-digestive tract were studied over a 12-month period. Of these, 73 percent were removed per-orally, or by indirect laryngoscopy. Fifteen percent were removed using the fibreoptic nasopharyngoscope. Twelve percent required a general anaesthetic and rigid oesophagoscopy for removal of fish bones at or below the level of the cricopharyngeus muscle. The technique has proven to be quick, well tolerated and low in morbidity. It is invaluable in patients in whom indirect laryngoscopy is unsatisfactory.

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Maroof, Mohammad, Mahmood Siddique, and Rashid M. Khan. "Difficult diagnostic laryngoscopy and bronchoscopy aided by the laryngeal mask airway." Journal of Laryngology & Otology 106, no. 8 (August 1992): 722. http://dx.doi.org/10.1017/s0022215100120687.

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AbstractA case of difficult diagnostic rigid bronchoscopy is described. However, flexible fibrescopy could be easily performed through a laryngeal mask airway despite complete lack of experience by the operator. Excellent visualization of the larynx and bronchial tree with minimal haemodynamic disturbance accompanied the technique.

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Vayisoğlu, Yusuf, Cengiz Özcan, Elif Sahin Horasan, Candan Öztürk, Onur İsmi, and Kemal Görür. "The Influence of Direct Rigid Laryngoscopy on the Nosocomial Colonization and Bacteremia." Journal of Craniofacial Surgery 25, no. 1 (January 2014): e89-e92. http://dx.doi.org/10.1097/scs.0000000000000429.

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Marchis, Ioan Florin, Doinel Radeanu, and Marcel Cosgarea. "Tracheal intubation with the rigid tube for laryngoscopy – a new method." Therapeutics and Clinical Risk Management Volume 15 (February 2019): 309–13. http://dx.doi.org/10.2147/tcrm.s190186.

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Marchis, Ioan Florin, Doinel Radeanu, and Marcel Cosgarea. "Tracheal intubation with the rigid tube for laryngoscopy – a new method [Retraction]." Therapeutics and Clinical Risk Management Volume 15 (July 2019): 957–58. http://dx.doi.org/10.2147/tcrm.s224147.

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Hendrix, Robert A., Aliya Ferouz, and Charles K. Bacon. "Admission Planning and Complications of Direct Laryngoscopy." Otolaryngology–Head and Neck Surgery 110, no. 6 (June 1994): 510–16. http://dx.doi.org/10.1177/019459989411000607.

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Increasingly, third party payers are challenging the necessity of a hospital admission for endoscopic procedures. Direct laryngoscopy (DL), with or without open, rigid esophagoscopy or flexible, fiberoptic bronchoscopy, was evaluated for the incidence of perioperative complications and associated risk factors. A retrospective review of 200 in-patient admissions between 1987 and 1990 for direct laryngoscopy or panendoscopy is presented. Complications were classified as major for untoward events that required hospitailzation for proper management. Complications were otherwise considered minor. The incidence of major complications was at least 19.5%, with minor complications occurring in 21% of patients. The total population was partitioned into subsets according to the occurrence of major complications, minor complications, and no complications. For the total population and each subset, distributions were developed by age, sex, habitus, physical status level, diagnosis of molignancy, presence of a malignant lesion in the aerodigestive tract, or medical history of head and neck surgery or radiation therapy. Statistical analysis indicates that these parameters do not offer reliable predictors of which patients are at risk for minor or major complications. It is concluded that all patients who undergo direct laryngoscopy are most safety managed in an in-hospital setting for a period on the order of 24 hours.

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Ku, Peter K. M., Michael C. F. Tong, Anne Kwan, and Charles Andrew van Hasselt. "Modified tubeless anesthesia during endoscopy for assessment of head and neck cancers." Ear, Nose & Throat Journal 82, no. 2 (February 2003): 121–25. http://dx.doi.org/10.1177/014556130308200213.

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We evaluated a modified technique of administering anesthesia without a tube and with spontaneous respiration during video-assisted tele-laryngo-tracheo-bronchoendoscopy (TLTBE). The endoscopy was performed as an alternative to rigid ventilatory bronchoscopy during screening for synchronous tumors in the tracheobronchial tree in patients who had head and neck malignancies. Thirty consecutive patients who required diagnostic panendoscopy were selected for this study. During direct-suspension laryngoscopy, anesthesia was delivered by administering intravenous bolus injections of propofol at 0.5 to 2 mg/kg every 5 to 10 minutes. A good view of the larynx, trachea, and main bronchi was obtained with a 50-cm 0° Hopkins telescope, which caused no obstruction of the airway. During laryngoscopy, arterial oxygen saturation levels, pulse rates, and blood pressures were stable in all patients. No apnea was associated with the use of propofol during any procedure, and we observed no intraoperative or postoperative complication in any patient. Video-assisted TLTBE is appropriate for patients with a grade 1 or 2 larynx, good cardiopulmonary function, and no significant airway obstruction. It is a safe and time-saving alternative to rigid ventilatory bronchoscopy for staging primary tumors and for screening for synchronous tumors in the respiratory tract.

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Setton, Antonio, Jeferson D'avila, Ricardo Gurgel, Domingos Tsuji, Daniel D'avila, Carlos Góis, Ana Meurer, and Helaina Gurgel. "Variant of the Technique for Laryngeal Microsurgery in Cases of Difficult Laryngoscopy." International Archives of Otorhinolaryngology 23, no. 01 (August 9, 2018): 018–24. http://dx.doi.org/10.1055/s-0038-1660825.

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Introduction Low exposure of the larynx can make laryngeal microsurgery difficult or even impossible. The application of rigid and contact endoscopy enabled oblique and retrograde angled visualization, allowing transoperative staging with greater reach of the anatomical areas. However, there is difficulty or even impossibility of performing the surgical act, due to the incompatibility of the angled path with the straight surgical tools. Objective To demonstrate the efficiency of the variant of the technique for laryngeal microsurgery in cases of difficult laryngoscopy and to analyze the new surgical instruments specific to the endoscopic procedure. Methods This is a cross-sectional retrospective study, based on the analysis of 30 medical records of patients treated surgically at a philanthropic hospital in the state of Sergipe, Brazil, between the years of 2014 and 2015. Results The technical variant used 30- and 70-degree endoscopes that provided complete oblique view of the endolarynx. The association of angled instruments (forceps, suction pumps, retractors and scissors) enabled the execution of the surgical procedures. Conclusion The association of rigid endoscopy with angled instruments promoted full visualization of the surgical lesion and operative resolution.

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